The Oncohumanities training programme: Fostering a deeper engagement and integration of oncology and humanities to tackle the pressing and complex challenges of cancer care

Introduction

Cancer continues to be one of the most pressing and complex global health problems. Cancer can involve the entire health system and the full life course of individuals. It is the second leading cause of death globally, ^a and is linked to significant health inequalities within and across countries.^1-3 For example, in high income countries 90% of children are likely to access a cure, while in the developing countries only 10% have a chance of survival.^1,4 Even in high income countries there are inequities in access to cancer care – which are linked to late diagnosis, but also overdiagnosis and overtreatment. ⁴ The ongoing disruptions caused by the COVID-19 pandemic are further exacerbating these disparities in access to cancer screening and care, increasing excess mortality. ⁵

Given the prevalence and complexity of cancer, optimising cancer care has become a key priority which includes other health systems challenges such as prevention and palliation. ⁵ Moreover, patient quality of life and more holistic and person-centred approaches are increasingly becoming a hallmark of cancer care. ⁶ Therefore, setting high standards for equitable and excellent cancer care can also work as a catalyst for the optimisation of a biopsychosocial model of medicine ⁷ – and a more patient-centred healthcare service provision. ⁴

Addressing these complex and far-reaching cancer challenges requires multipronged strategies and a truly multidisciplinary approach, within and beyond cancer care and medicine.^4,8 Multidisciplinary training and research in oncology represent an important foundation of such a multipronged strategy.

The European School of Oncology (ESO) – an independently funded non-profit organisation dedicated to quality training and providing oncology education to help the improvement of cancer patients’ treatment – has developed an innovative educational postgraduate programme in Oncohumanities (to be launched in 2023). At the core of this training is the new term ‘Oncohumanities’, defined as the set of deep reflections on conceptual, sociological, anthropological, and ethical issues, that allow the integration of technical aspects of cancer treatment with what is necessary to render them humane on the basis of an understanding of patients’ multilevel life course experience of cancer, and the respect of their autonomy, dignity, and of their life-style, values and beliefs. The programme enables oncologists to advance individual competencies and strategies to bridge the gap between daily practices and humanistic reflections on these practices, for the benefits of the patients.

The Oncohumanities training programme

The Oncohumanities training programme provides state-of-the-art best knowledge on conceptual, sociological, anthropological, and ethical debates focusing on research, decision-making and diagnosis, treatment options and planning of oncology care. The main objective of the programme is to improve knowledge underpinning oncology practice, and to enhance the oncology practitioner’s sensitivity to person-centred care attitudes based on the humanisation of care, on empowerment of the patients, and on respect for their diversities. To the best of our knowledge no continuing education programmes in Oncohumanities – understood in this broad meaning – are currently offered.

This unique programme, albeit developed for oncologists, is also open to any healthcare practitioners, and to non-hospital personnel interested in humanities-related issues in oncological settings. The programme will include:

The novelty of this training programme: The Oncohumanities approach

The fundamental novelty of the Oncohumanities programme lies in its methodological approach: it is integrated to and engaged with the medical practice of oncology; and it draws on a wide range of humanities disciplines.

This approach is radically different from most past and existing humanities training in oncology (and general medical humanities) ⁹ – e.g. narrative medicine or art and medicine approaches – which tend to be ‘add-ons’ to oncology (and medicine), and may not always be of relevance to, or up to date with, the real daily clinical challenges and needs arising from oncology practice. The Oncohumanities programme aims to provide oncology healthcare practitioners with the competencies to better understand the human implications of oncology care; that is to better understand the needs of the patient beyond the strictly biomedical aspects of oncology care.

Therefore Oncohumanities promotes a novel understanding of humanities which includes subjects like philosophy of science, anthropology, ethics and sociology; and considers humanities as being integral to the core oncological curriculum itself; or, in other words, to the key competences of a good oncology healthcare practitioner (see Figure 1).

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Figure 1.

Oncohumanities is integrated to oncology practice and provides tools and competencies for oncologists to better understand the human implications of oncology care.

Although the Oncohumanities programme is novel in the field of oncology, there are similar examples of strong integration of humanities with different medical and scientific disciplines. Recent examples can be found in relation to science and philosophy; ¹⁰ neuroscience and humanities (‘neurohumanities’); ¹¹ ethical counselling in genomic medicine; ¹² as well as the development of real training models which introduce humanistic studies to a scientific environment. ¹³

This new Oncohumanities approach - by fostering a strong integrated partnership between humanities and oncology - will benefit oncology training and practice, and ultimately patients. We outline the main features of this integrated and engaged approach below (for an in depth discussion of this see Boniolo et al.) ¹⁴